Calcium supplements a waste of your money?

Osteoporosis is a common disease of old age in which a progressive decrease in the density of bones weakens the bones, making fractures likely.

Our bodies constantly build new bone and remove older bone. In children, more bone is built than removed, and so the bones grow in size. After age 30 or 40, however the body may fail to form enough new bone, or too much old bone may be reabsorbed, or both.

There is no single cause of osteoporosis. Many factors contribute to a loss of bone as people age.

Menopause is accompanied by lower oestrogen levels; oestrogen helps build bone. The total amount of bone then decreases, and osteoporosis may develop as a result. Other factors however are also important including lifestyle, low body mass index, disease and medications.

Osteoporosis is largely preventable for most people. Prevention of this disease is very important because, while there are treatments for osteoporosis, there is currently no cure.

Building strong bones, especially before the age of 30, can be the best defense against developing osteoporosis.

Being a multifactorial phenomena, prevention of osteoporosis requires more than just supplementing your diet with calcium.

Controversy concerning the role of calcium in the middle-aged and elderly, arising out of population studies showing sometimes only weak calcium effects, can be resolved by recognizing the multifactorial character of the disease, and by careful attention to

such details as national differences in habitual calcium intakes¹.

The following are among the proven effective measures in the primary prevention of osteoporosis; no one step alone is enough to prevent osteoporosis but all three may²:

1. Lifestyle Modification

• Avoid smoking, excessive alcohol and caffeine
• Regular weight bearing exercises such as daily walking.

2. Calcium and Vitamin D Supplements

· The recommended daily calcium intake for Malaysians is 800 mg.

· Vitamin D helps in maintaining normal calcium absorption and metabolism. Exposure to sunlight is a major source of Vitamin D. Recommended vitamin D intake above the age of 50 is about 10 ug/day (about 200-600 i.u.)

· Food that contains high calcium and vitamin D such as milk, cheese, egg and cod liver oil should be encouraged.

3. Medication Preventing Bone Loss

· These are potent drugs which requires a proper assessment by a qualified medical practitioner before use. They include bisphosphonates, estrogen replacement therapy and raloxifene.

1. R P Heaney. The calcium controversy: finding a middle ground between the extremes. Public Health Rep. 1989 Sep–Oct; 104(Suppl): 36–46.

2. Loh KY, Shong HK. Osteoporosis: primary prevention in the community. Med J Malaysia. 2007 Oct;62(4):355-7